Journal of Artful Short Stories and Poems

Cover Me - A Healthcare Memoir (Excerpt)

by Sonya Huber

New Chapt. One

My sinuses throbbed and pressed against the bones of my face like overcooked bratwurst. I pulled open the glass door of the community co-op in Columbus, Ohio. I wanted to fill my skull with brightly colored vitamin cocaine and blot out the suicide-gray Midwestern sky.

Yes, I should probably have been sitting in a doctor’s office.

I was an adjunct teaching writing at a local university. I was uninsured—or so I thought, but that’s another story. The human resources lady didn’t even mention health insurance during our two-minute tax form session that fall. No benefits packet arrived in my mailbox, so I assumed I was in the lecturer job class with all the other gun-for-hires on campus. My husband, a self-employed carpenter, fixed his swollen thumbs by drilling holes in his fingernails to let out the pus. We were do-it-yourselfers of the involuntary variety.

I spent my days swilling coffee, wincing at the onslaught of traffic and lateness and e-mails. I ate Sudafed like cinnamon red-hots. As if my southside Chicago accent wasn’t nasal enough (Chicauuuuugo), I honked with the voice-squeezing pressure of the constantly congested.

I wanted to lie down on the brownish-gray carpet and wait for a vegan staffer to drag me into the break room and heal me with camphor-and-echinacea steam and homeopathic herbal tinctures.

Insurance was invented for ship captains in the 1660s who needed protection from the risks of the frothing, pounding sea. Once insured, these seamen could leave their wrecked vessels to founder on the rocks. Insurance was described in 1665 as “[t]he Covenant of preventing Danger… [which] added a Shadow of Law; whereby the incertainty of the Event is usually transferred to another, with some certain Reward.”

The only reward I wanted was the safety that was so near and just out of reach. It seemed to circle, to splash and taunt me, in whale-like SUVs that circled the perimeter beltway of I-270, each shiny vehicle filled with moms and kids who clearly did not worry about medical bills.

In those months I drove the snow-sludged highways toward the babysitters or job #1 or job #3, all freelance gigs without benefits. In a boil and fester of envy I hated the SUVs and their drivers because each of those people was covered and therefore safe. They lived in another universe where bodies and treatments paired and came together effortlessly like ballroom dancers in layers of chiffon and satin.

I didn’t want their cash. I had enough. I paid for coffees with my girlfriends, dropped an occasional $15 for a sexy shirt on sale at Urban Outfitters, and had enough pocket change for books, garage-sale clogs and thrift-store sweaters, for movies and sushi and Indian food and all the other markers of comfort for a Midwestern white girl with a few master’s degrees. I had credit card balances and debt, yet I was also highly attuned to the aesthetics of a nice shoe. The skim latte cup was either half empty or half full. I didn’t want cash; I wanted coverage.

In the co-op that fevered and shivery day, I locked eyes with an Odwalla Immunity Support Mango-and-Berry Smoothie. I’m sure you’ve seen them: about four bucks for four mouthfuls of super-healthy puree. Anyone who shells out cash for that scam has only themselves to blame.

The plastic bottle of juice stood with its cousins, shoulder to shoulder, all colors of a tropical Gaugin painting of Tahiti, in a low cooler near a tall shelf of ground yarrow root and feverfew. Cheaper juices stood in uneven rows, their dusty glass surfaces adhered with stickers, $2.00 each, offering the exact same nutrients and vitamins. The cheap juices wore labels were slightly less pretty, the ad copy slightly more modest and realistic.

In a magazine rack at the front of the co-op, near the cash register, my safe and successful alter-ego cavorted in ads for Green Investment and Eco-Tourism on the pages of The Utne Reader. She was a writer in Seattle or Santa Cruz, pulling her Aveda-scented hair into a ponytail, shrugging off her name-brand polar fleece, and then chugging a $3.99 Odwalla Immunity Support Mango-Berry Smoothie as she pilots her new hybrid Prius on the way to a three-day yoga retreat.

I didn’t want to be her.

Oh, shut up. Of course I did. I wanted to flaunt to the world, to imply with my Aveda-smelling skin and my woven fair-trade handbag that I had the embrace of Jesus and Buddha, the salvation security. I wanted to show the world the clear skin and steady gaze that comes from nights of easy sleep, organic vegetables, and lack of stress.

But this was something different, a low point for me in which specific irrational costs and benefits tipped the scales toward Odwalla. Granted, I remember that day partially because of the left-hook sent by the hippie universe before I would even finish drinking that bottle of juice. But I’ll get to that.

What I see there, looking at that woman standing in front of the cooler, is healthcare fatigue. I see a woman who wanted an Odwalla bedtime story of comfort, the same safety I exuded to my baby son when I read him Snuggle Puppy for the three-trillionth time. I wanted to hear that the flannelled low-income princess could afford to make herself healthy.

I clearly could not. An office visit and prescription for my sinus infection would have set me back one hundred dollars.

Maybe, instead, four bucks would work. It wouldn’t, of course.

Wait. What I needed was the curative and sustaining break from sanity. I needed three minutes, eight swallows or so, in which simple faith would grant me the illusion that my actions mattered, that about my own body was under my control.

By age 33 I had yelled into a megaphone on the steps of the Ohio Statehouse for universal healthcare. I had enrolled my baby son in the state program for low income families. I had seen my picture in the newspaper and heard my voice on the radio yelling about healthcare.

By age 33, I had already been sent to collections several times for medical debt. I worried about money, which sent cortisol and other stress hormones coursing through my body, triggering the flight or flight response that proclaimed an emergency and then subtly wore me down with the effort of staying on physical alert.

By age 33, I had lived through eleven gaps in healthcare coverage. During each, I wore a groove of worry in my frontal lobe that seemed directly connected to my lymph nodes, white blood cells, and serotonin levels. Now I want to know what life would have look like without that undercurrent of healthcare anxiety and longing. I want to see a version of myself, body and mind, without that skein of tension.

Most of my friends cycled in and out of the same circus. Everybody coped in different ways. The drunks told each other that beer sterilized your throat when you had a cold. The hipsters, who had formerly spent their time bitching about how punk was not dead, developed secondary specializations in acupuncture, green-algae pills, cranio-sacral massage, wildflower homeopathic tinctures, Reiki, Chinese medicine, and various other non-Western therapies.

I’d already done Catholicism and considered my debt to hocus pocus to have been paid. At that time in my life, I was able to finally hear the word “chakra” without throwing up, but I harbored a lingering distrust of New Age-y thinking. But I also wondered if maybe my hipster-cum-hippie friends had it right. They could take back a portion of control over their bodies. Instead of worrying, I should have been romancing my adrenal and lymph systems, cooking organic stir fry and meditating placidly while holding my sleeping infant son.

Drumming circles aside, the hippie culture of green algae pills and I had come to a sort of detente, because it seemed that receiving a squirt of herbal Rescue Remedy under the tongue took less time than whispering an extra Hail Mary. Like a Catholic who gets baptized just in case, I shrugged and accepted anything that might conceivably work, including the placebo effect.

Nobody wanted to toss a barstool over the cost of an ER visit or launch a punk-rock throw-down about an uninsured root canal. My women friends bitched about their boyfriends over coffee but didn’t dredge up a meaty curse toward their health plans. Fixing healthcare was more hopeless and pointless than waiting for the addict to stop drinking, than getting your brother to pay you the $300 he owed you, than waiting for your favorite band to get back together. Forget it. There’s always bankruptcy.

I cradled the juice in my sweaty hand, pushing a hank of long brown hair behind my ear. My glasses were probably fogged up with the transition from gray-wet-cold outside to the steamy warmth of the co-op. I sniffed. I was tired, sick of carrying shredded coupons in my coat pockets. Sick of looking for the cheapest toilet paper. Sick of holding up the grocery lines with my WIC coupons while the cashier rolls her eyes and the people behind me look me up and down. I hated the bleak cast that had settled over life itself for its potential expense. Every slip and fall, every cough, glinted with the knife-edge threat of a serious condition, a hospital visit, a debt of several thousand dollars I couldn’t repay.

Some weakness—a fever surge or a howl of wind outside or a sinus pang—decided it.

The cool, sweet liquid splashed down my throat. Its thick texture felt healthy and substantial, as if it could flow to a fever-thin weak spot and fill it like vitamin spackle.

In other words, I lobbed my desperation toward the icons I worshipped, like lighting a novena candle in front of a Virgin Mary statue. As if in throwing money--$3.99 plus tax—toward my healthcare deity, I could curry favor.

This is the story of my torrid and twisted love affair with health insurance.

I had known its embrace. Each blissful fling unfolded with delicious expectation, wet with whispers of forevermore. I entered these brief affairs with pink hope and the best of intentions. New health insurance cards—coy valentines—always arrived in plain white envelopes. Each plastic card was like a hotel room key that unlocked its own universe of safety and security, and each had its own rules. Savoring my good fortune, I browsed the provider listing and chose a fresh crew of doctors to peer into my orifices. The courting and flirting began with a bit of game-playing, the waiting periods and the occasional denial of coverage for pre-existing conditions. After the rush of anticipation and insecurity that comes with new love, I made myself at home in each network, scattering the fragments of my medical history behind me like a trail of crushed candy hearts.

Take me. I’m yours. Hold me and never let me go.

I graduated from college in 1993 and leapt from the shelter of my parents’ healthcare plan. The next fifteen years earned me a scattershot range of paychecks at 25 jobs. I was a receptionist many times over, a mental health counselor, a proofreader, writer, editor, reporter, assistant publisher, bookstore clerk, writing teacher, and community organizer. Eight of these gigs came with health insurance, and I latched on to those eight health plans with a desperation the employers often didn’t deserve. I backed myself into gray-partitioned cubicles to get screwed by boring, dead-end, or degrading jobs, faking enthusiasm all the way for the healthcare payoff.

Maybe I gravitated towards loser, slacker, emotionally unavailable jobs that wouldn’t support my healthcare needs. I’ve always had a thing for the bad boys, and maybe I kept unconsciously choosing those chain-walleted, tattooed health plans that looked fine in the dim and smoky light of a fling. The second my body exhibited a need, however, these health plans turned grouchy and distant, coughing up loopholes and denials of coverage. Maybe my full-coverage, low-deductible dreamboat was still out there somewhere, bobbing above the surface of the ocean as I muttered “plenty of fish” and sorted the bottom-feeders below.

My healthcare hookup story is remarkable only in its mediocrity. I tried so hard to find The One and to discern The Rules. I hated the anonymous tryst of an emergency room visit, the feeling of a stranger’s hands on my body and the knowledge that his parting words of “good luck” would be the last I’d hear from him. I wanted a prince charming—a general care practitioner, a personal care physician, a referring physician—to arrive with a flowing mane and a fistful of referral slips. I wanted to go to an HMO where everybody knew my name.

As much as any placebo works, I felt better immediately. I was playing an active role in my individual healthcare destiny, playing Healthcare.

Taking another sip, I took my place in line at the register. When I got to the front, I presented my co-op membership card and paid the three bucks and change, signifying to myself that I was on the side of the healthy and those destined for health.

I was that woman in the hippie ads, or I could fake it and pretend I was in a land where $3.99 was not that big of a deal. And somehow, this juice, this brief respite from penny pinching, unknotted my shoulders and my chest. The juice tasted lovely, sweet and tang whirled with a slight grit.

We can’t always be hard, I was saying to myself, and that is also an okay lesson. Poor can’t always mean the cheap juice. Strangely enough, those respites are part of how we gather strength for more discipline. That I believe. Crisis addressed, I swirled some juice around my teeth, sipped something complicated about my own weakness and my own need to acknowledge it, off and on. I wavered in overlaps between the wooze of shame for a needless purchase and the shrug of water or smoothie under the bridge. Fevers would pass.

I wanted to finish the juice inside in the warm co-op before buttoning my coat and heading out, chin tucked into my collar, into the whipping wind. I crumpled the receipt into my pocket and walked from the cash register toward the co-op bulletin board on the front wall. The bulletin board was covered with colored paper, hand-drawn ads promoting eco-friendly house-cleaning, tantric pet-minding, a workshop for learning how to build your own herb garden.

Then I saw it: Living Serenely without Health Insurance.

A flyer for a workshop sponsored by a local sustainable-living reading group.

Serenely. Mango puree pooled beneath my tongue as my bloodstream flushed with adrenaline. I stared at the flyer, riveted. I had never entertained the vile union of these two concepts: serenity and uninsurance.

I respect people who can talk about having gratitude for their addictions, who feel blessed by their cancers, and the like. But I am not yet on that spiritual plane. I am clearly somewhere far beneath it, in an underground foxhole of healthcare. I had to force myself to take in a breath. Maybe it was the fever, but I felt attacked by that innocent poster, which seemed to be calling me out as the spiritual midget I am.

The truth was that I wanted more than anything else to live serenely without health insurance, but I wasn’t sure whether that fantasy was akin to “peace within domestic violence” or “finding your pocket of calm in racial apartheid.” Both of those things—strangely, profanely—are necessary, of course, and yet evil to contemplate.

I wrapped my coat around me, shoved my orange knit ski cap on my head, and pushed open the glass door against the wind, gripping a half-empty bottle of juice that had lost its magic. I found my slush-encrusted car and blasted the defroster, watching the windshield wipers grate over hunks of ice on the windshield. I probably took off my glasses and cried, head down on the steering wheel, fever-flushed.

I probably fumbled with my metal-cold cell phone and called my friend Kathy, a divorced single mom living with her two kids in her parents’ basement. We laughed at each other’s bad days, not unkindly, because we seemed to trade the same day back and forth as we traded tips about where to apply for low-income childcare and moaned about picking up bulk quantities of peanut butter from the WIC office.

“Oh, honey,” she might have said. “Sounds like you need the ‘Open.’”

The “Open” was an antique metal fob that probably once hung in a store window. I don’t know where it came from, but over the years of our friendship it had somehow became our Buddhist reminder to look for whatever was coming around the next bend and keep an open mind, despite the crap of motherhood and genteel college-educated poverty. One of us would carry it for awhile, and then when need arose we’d dig it out from our purse or pocket and transfer it like a talisman.

The Open: I didn’t want it or its message. What would the wise thing be: to have an open mind about stuff like “Living Serenely without Insurance?” Or an open mind about the hope of getting out of this situation? Why would I open myself to a situation in which I already felt shredded and exposed?

I picked up the baby from the sitter, swaddled him in layers of polar fleece and knit, wrestled him into the car seat, and drove home. I fed him and put him down for a nap. Then I searched the Internet for serenity no health insurance. I wanted at least to see the argument, to pick it apart with my brain and my teeth, to ravage it or to throw myself onto it for safety.

Sure. Even better. Whatever. I clicked on the link. The screen listed Christian Web sites offering group prayer for the ill and private financial assistance for the Saved. Several other search terms, a visit to Amazon, a troll through a news database all turned up nothing. This secret was so underground it was nowhere on the Web.

Fine. I would attend the workshop.

I went back to the co-op a few days later to copy down the date and time, but the poster was gone.

The Odwalla moment of this love story holds special meaning for me now because I can look back and know what my ski-capped then-self did not know. Like strangers in the night passing each other unawares, my one true love, my coverage, had been wandering around in the world without me. I had been technically eligible for full health benefits, but no one told me about it.

I recovered from the sinus haze and the sun warmed the Midwestern ground. I dusted off my resume, applied for another benefits-eligible job on campus, interviewed, and eventually got the job. I broke the happy news to my boss, who understood completely that I needed more security for myself and my family. I collected binders of information and syllabi to pass on to my replacement and recommended candidates for my job.

In the late spring, post-sinus infection and just as the school year was winding down, I was finally starting to receive campus mail with some regularity. It had taken several signs and mailboxes in two different mailrooms in the massive College of Engineering complex to get my mail routed to the correct room.

On one of those mailers, maybe something from Human Resources, I happened to see the letter A listed after my name on the label.

Maybe I am adding this in retrospect: a wave of nausea that comes with the knowledge of databases and codes. At the very least, my curiosity was piqued. At most, I was flung into a panic. I knew the Human Resources benefits codes. I knew they went by letter. I can’t explain, sweet Jesus…I knew it. Looking at that mailing label was as horrible as replaying the moments that lead to a car accident. No. Don’t tell me that every moment of stress this past year would go into a deep well of meaninglessness.

I went online and opened the HR benefits spreadsheet, and yes, A was a benefits-eligible job code. Okay, maybe this A meant something else, some other field or marker carrying different meaning.

I called the College of Engineering Human Resources office, and the woman there told me to call University HR. After waiting on hold, clutching the mailer and trying to breathe, I explained my strange question: “Can you tell me whether I’m an A job code?”

The man scrolled and clicked. “Sorry, the computers are freezing up today.” A sigh and the sound of clacking keys. “Okay, here we go. Uhhh, yep. Yeah, that’s you.”

I tried to breathe, and what flashed through my mind were a thousand scenes of the past year and the year before that. Talking with my state healthcare caseworker. Faxing in re-applications for my son’s coverage. Tallying, adding, writing checks, but most of all the bleak, gray sickness of worry.

I wanted to hunt down that worry and stab it, kill whatever had caused each one of those lost moments.

“Can you tell me what address you have for me in your system?” I asked, with the false-calm over-enunciation of a woman trying not to lose her shit on someone in customer service who doesn’t deserve anonymous abuse.

The address he read back was a general one for the College of Engineering.

“Yeah, it looks like your benefits materials were sent to that address, but they were never sent back.”

I knew exactly where my benefits packet had gone when I’d been hired: up to the third floor in the College of Engineering, where my mail often was inexplicably sent. At the beginning of the year, I didn’t even know that this third-floor mail whirlpool existed and I wouldn’t have known then to check up there. The third-floor office folks hadn’t known me at that time and didn’t know to send it down to me.

“How could this have happened?” I asked.

The HR person on the other end of the phone seemed slightly baffled about the emotional and ultimately unknowable nature of my question. He said something like, “Well, you’re eligible now, so if you want to sign up, let me know. Is there anything else I can do to help you out today?”

Me, this body who had been scraping by, unworthy, unsecure and on the edge—I’d been important enough this whole year to be insured, to be safe, and I hadn’t known it. That’s the scrim of my sickness, just the shining edge of it, that I could feel retroactive self-esteem based on benefits eligibility, that I could also mourn for a year in which hypothetical benefits had gone unused.

Eyes wide, I swiveled my chair to face my boss, who worked across our small office in the cubicle opposite me. I waited for him to say the words, the name of a person whose head should be delivered on a platter to the dean.

“That’s too bad,” he said with a sympathetic wince and a smile. “Sorry about that.”

Never mind. I could summon my own rage. I wanted someone punished, but I didn’t know who to attack. I went down to the College of Engineering Human Resources office, and the woman there confirmed that the package had probably been misrouted.

Wasn’t it a legal requirement, I asked, to have documentation and a signature on file when a benefits-eligible employee refused benefits?

The new HR woman squinted at me. She’d just started the job. Her predecessor didn’t have any records of the mailings. There was no way she could say for sure what had happened, and certainly there was no human to blame.

Those benefits had been mine, I argued. Their retroactive absence from my life was mine.

No, said the new HR woman. There was no hole to be documented and filled by the absence of benefits past, no wrong to be righted when dead benefits were found to be missing. They were fringe, decoration, given at the pleasure of the employer and vanishing like day lilies the moment their short lifespan had passed. Fringe—as in rickrack, tatting, pompoms, and lace.

I found my car in the parking garage and went home in a daze.

My main goal for years had been to vault myself from benefits wasteland into a “real” position. That, tellingly, was how my friends and I talked over coffee, comparing notes, described employment, in terms of a real job. A real job for a real person. A real person—a real mother—who could afford to pay for health benefits for her real child. Love made the Velveteen Rabbit real; even though time wore out the stuffed animal, its missing stitches and holes were proof of the child who loved it.

Health itself was no bedrock, and the body would break in time. But benefits were safety and future, lullaby and go to sleep, my feminist version of Prince Charming on a white horse, love incarnate, the thing that would make me real, would catch me when I fell and would set me back on my feet. I could not even think of myself or my life without thinking about my insurance status, and I had narrowed my sense of foundation and tomorrow to the size of a wallet-sized white plastic card.